Edgar Ontiveros

NPI #1891517124 in Clearlake, California

Provider Information

NPI Number
1891517124
Entity Type
Individual
Name
Edgar Ontiveros
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Peer Specialist
Enumeration Date
Oct 28, 2024
Last Updated
Oct 30, 2024

Practice Location

Address
14096 LAKESHORE DR
ZIP Code
95422-8160
Phone
(707) 994-4261

Specialties & Taxonomy Codes

Specialty
Peer Specialist

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